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修复前外科手术——叙述性综述与当前争论

Preprosthetic Surgery-Narrative Review and Current Debate.

作者信息

Terheyden Hendrik, Raghoebar Gerry M, Sjöström Mats, Starch-Jensen Thomas, Cawood John

机构信息

Department of Oral & Maxillofacial Surgery, Helios Hospitals, 34121 Kassel, Germany.

Deptartment of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.

出版信息

J Clin Med. 2023 Nov 23;12(23):7262. doi: 10.3390/jcm12237262.

Abstract

This review describes the role of modern preprosthetic surgery. The atrophic edentulous jaw can cause severe functional impairment for patients, leading to inadequate denture retention, reduced quality of life, and significant health problems. The aim of preprosthetic surgery is to restore function and form due to tooth loss arising from congenital deformity, trauma, or ablative surgery. Alveolar bone loss is due to disuse atrophy following tooth loss. The advent of dental implants and their ability to preserve bone heralded the modern version of preprosthetic surgery. Their ability to mimic natural teeth has overcome the age-old problem of edentulism and consequent jaw atrophy. Controversies with preprosthetic surgery are discussed: soft tissue versus hard tissue augmentation in the aesthetic zone, bone regeneration versus prosthetic tissue replacement in the anterior maxilla, sinus floor augmentation versus short implants in the posterior maxilla-interpositional bone grafting versus onlay grafts for vertical bone augmentation. Best results for rehabilitation are achieved by the team approach of surgeons, maxillofacial prosthodontists/general dentists, and importantly, informing patients about the available preprosthetic surgical options.

摘要

本综述描述了现代修复前外科手术的作用。无牙颌萎缩会给患者带来严重的功能障碍,导致义齿固位不足、生活质量下降以及严重的健康问题。修复前外科手术的目的是恢复因先天性畸形、创伤或切除性手术导致牙齿缺失所引起的功能和外形。牙槽骨丧失是由于牙齿缺失后废用性萎缩所致。牙种植体的出现及其保存骨组织的能力开创了现代修复前外科手术的新局面。它们模仿天然牙的能力克服了长期存在的无牙问题及随之而来的颌骨萎缩。文中讨论了修复前外科手术存在的争议:美学区域软组织与硬组织增量、上颌前部骨再生与修复性组织替代、上颌后部窦底增量与短种植体——垂直骨增量的植入性骨移植与覆盖式植骨。通过外科医生、口腔颌面修复医师/普通牙医的团队协作方法,并且重要的是,告知患者可用的修复前外科手术选择,可实现最佳的康复效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac7/10707555/3fd052949b65/jcm-12-07262-g001.jpg

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